Problems in Pregnancy & Birth

Although the majority of women go through their pregnancy without any problems, pregnancy is a complex process and occasionally some things do go wrong.

Ectopic Pregnancy

Fertilised eggs are supposed to travel through the fallopian tubes and end up in the uterus. In an ectopic pregnancy, however, the fertilised egg implants outside the uterus. In most cases it remains inside the fallopian tube. It can also occur in the abdomen, cervix or ovaries.

The effects of ectopic pregnancy can be quite serious, because these other areas are not designed to support a growing foetus. It can cause, rupture, internal haemorrhaging, and possible death.

Miscarriage

Miscarriage, also called a spontaneous abortion, is a natural termination of a pregnancy before the time that the foetus can live on its own. Approximately 10% of all diagnosed pregnancies end in miscarriage.

Miscarriages can also occur in the second and third trimesters although the percentage drops dramatically after the first trimester.

Symptoms of miscarriages include vaginal bleeding, cramps and lower back pain.

Chromosomal Abnormalities

The risk of chromosomal abnormalities increases as a woman ages, and chromosomal abnormalities can result in many different problems.

Sometimes doctors will know where the chromosomal problem lies and how it will manifest itself, but other times they just don't know. The most common abnormality appears in the 21st chromosome and is known as Down syndrome.

Rh Incompatibilities

The Rh factor naturally exists on some people's red blood cells. If you blood type is followed by a + you are Rh positive, if not, then you are Rh negative.

A father who is Rh positive often passes on his blood type to the baby. If the baby's mother is Rh negative, any of the foetal blood that comes into contact with hers, which can happen during the delivery, will cause her to begin to make antibodies against the foetal blood.

This in turn may be dangerous for future pregnancies. Because the mother has made antibodies to Rh-positive blood she will reject the foetal Rh positive blood, which can lead to foetal death.

After an Rh negative woman has delivered she is given an Rhogam, which prevents antibodies from forming and ensures that future pregnancies will be healthy.

Toxemia

In the last 2/3 months of pregnancy, around 6% of women experience toxaemia also called preeclampsia. Symptoms include rapid weight gain, fluid retention, an increase in blood pressure, and protein in the urine.

If toxaemia is allowed to progress, it can result in eclampsia, which involves convulsions, coma and in some cases death. These conditions, which occur primarily in women who neglect good prenatal care, are relatively rare in women with good medical care.

Premature Birth

Birth that takes place before the 37th week of pregnancy is considered premature birth. However, the majority of babies are born late rather than early. Prematurity increases the risk of birth-related defects and infant mortality.

Birth may occur prematurely for several reasons, including early labour, early rupture of the amniotic membranes, or because of a maternal or foetal problem. Other factors that may lead to a premature birth include smoking during pregnancy, alcohol or drug use, inadequate weight gain or nutrition, heavy physical labour during pregnancy, infections and teenage pregnancy.

Breech Birth

In 97% of all births, the fetus emerges in the head-down position. However, in around 3% of cases, the foetus is in the breech position, with the feet and buttocks against the cervix. About half of all foetuses are in the breech position before the 7th month of pregnancy, but most rotate before birth.

When doctors are aware of the position of the foetus prior to delivery they can try to change the foetus position for normal vaginal delivery. Often a caesarean section will be performed to ensure the health and well-being of both the mother and her child.

Stillbirth

A foetus that dies after 20 weeks of pregnancy is called a stillbirth, prior to 20 weeks it is called a miscarriage. There are many causes for a stillbirth, including umbilical cord accidents, problems with the placenta, birth defects, infections, and maternal diabetes or high blood pressure.

Often a stillbirth is completely unexpected, as half of all stillbirths occur in pregnancies that appeared to be without problems.

Many women are advised to do ‘kick checks' beginning in the 26th week of pregnancy. If a woman notices that her foetus is kicking less than 6 times in an hour, or has stopped moving or kicking, foetal monitoring can be done to check on the status of the unborn baby.